Pregnant but Negative Urine Preg?

Specialties Ob/Gyn

Published

Hi all! I'm an ER nurse, and had a pt last noc who swore up and down "there's no way I can be pregnant....my period is 4 days late, but I took a test (urine) this morning and it was negative" The doc wanted to do a serum beta, and lo and behold PREGNANT! Thought I would come to the source and see if any of you guys know how common this is. I've had a couple in the last 6 months (one was a urine preg we did 2 days previous, pt came back and we did a beta).

Anyone know what the percentage is of women who don't show positive on urine HCGs?

Specializes in ER, NICU, NSY and some other stuff.

THe levels will go down slowly over a matter of days to a couple of weeks.

Another possibility is that if the HCG is very high, beyond what the test can read you will get a neg result. Say the test can read from 100miu-100,000 if her beta quant is 150,000 you would get a neg result.

Specializes in ER, critical care.

I have only seen this once with a urine hcg done in the ER. It may have happened more often and been caught at office later. However, this one was discovered after the woman had a CT scan for abdominal pain (after neg urine hcg) and fetal bones were found in the uterus on CT.

Talking to the woman afterwards, she told us she had been pregnant 3 times and all 3 times it was never detected by urine hcg only by serum. I don't know what that was all about.

Specializes in Looking for a career in NICU.
I've seen a urine pregnancy test in a lab show positive two weeks after delivery.

Thanks for the clarification!

Specializes in med/surg, telemetry.

With all 5 of my pregnancies, my home urine tests would not show up until I was nearly 8 weeks pregnant. Even when I went to the doctors prior to that 8 weeks, the urine tests would show negative. They would have to do a blood test to confirm the pregnancy prior to 8 weeks. I think some women just don't produce that much HcG at the beginning of the pregnancy, as I believe I'm one of them. There are just so many variables that can give false readings.

Specializes in Cardiac Thoracic Surgery, Emergency Med.

Could be tubal pregnancy. Those don't show up in urine tests. At least that was in my case.

Specializes in ICU, PICC Nurse, Nursing Supervisor.

Tubal pregnancy's produce HCG just like any other pregnancy. The levels just may not double every 48 hours. Molar pregnancies tend to produce abnormally high amounts of HCG. With this pregnancy my LMP was 6/13/06 , I conceived this baby on 6/27/06 (100% positive) and my Urine Pregnancy test was positive 7/4/06. That is 7 days later, I am like clock work because the hormones start flowing and I start getting very evil....so I to run to Wally world....

Could be tubal pregnancy. Those don't show up in urine tests. At least that was in my case.
Specializes in ICU, PICC Nurse, Nursing Supervisor.

And on the other end I have lost a baby and had to take a urine pregnancy test. Because if all the placental parts do not come out the body will still produce HCG ( I did not have a D&C) . Three weeks after I was still positive ,small amount though and I had not retained any placental parts.

Specializes in PCT.

We once sent a girl to x-ray after a negative Hcg, lo and behold she was about 8 1/2 months pregnant. The x-ray was beautiful although we were all quite worried. She was a bigger girl and had no idea she was about to have a baby. Neither did we. The ED doc said that sometimes late in pregnancy urine tests don't show anything.

Long, Long time lurker here but had to "come out" on this post. I am a pre-nursing student in N.C. Mother to 4 children with my last 2 being pill babies. I am one of those who had complete negative pregnancy tests with my last child and had no idea I was pregnant till I was well into the pregancy and I get the "How could you not know" question all the time. Which I completely understand considering it was my fourth. I was on a double dose of b.c. pills considering my baby before was a pill baby. This one though-my period was late, took the test and it was negative. Didn't think much about it. Moved a house full of furniture with my husband since we were relocating from V.A. to N.C. No trouble there. Got to new location started job hunting for about 2 months couldn't land a job for anything and currently had about 10 years exp. as a medical secretary. Got life insurance- had blood work done for that and nothing showed up. Got health insurance had blood work done again- nothing showed up so opted out of the maternity coverage. Why would I need it??!!! Didn't give much thought to not having a period. I new we had some female issues in our family so I was beginning to think I needed to make an appt soon but no rush since I felt great and with other pregnancies had my head in the toilet constantly!! Finally in the middle of October i was laying in the bed and felt a kick. Totally freaked out and told my husband and he couldn't believe it either. I knew I had gained some weight but thought because I was staying home more I was eating more. Went to get on state health insurance for the pregancy but that took the entire month of October for processing, took me another month to get in at the OB office so my first appt was just before Christmas 2004 and I had a healthy baby in March 2005. Wouldn't trade her for anything. I was told by my ob that it being negative for so long can be an indicator of some trisomy conditions. Not sure if that's 100% true or not. Just putting out there what I was told.

Anyway just wanted to put our family's story out there as we get this question quite a bit when we share about our surprises. I've learned so much from this site and hopefully will post more in the coming weeks. With four children under 7 we stay pretty busy around our house. I'm currently on a break from pre-req's. Will attempt another class in the spring. Thanks for letting me jump in.

Specializes in Cardiac.
?? Doesn't the fact that the HCG stays positive indicate a molar pregnancy or something like that? I thought that the increased HCG after a miscarriage indicates molar and then in turn that the increased HCG can lead to endometrial cancer? I may be confused....

I didn't say they increased, I just said they don't instantly drop after delivery.

I didn't say they increased, I just said they don't instantly drop after delivery.

ah okay thanks! :)

Specializes in Orthosurgery, Rehab, Homecare.

Had a friend who had HPT's that read, in order, +, -, -. Turned out later that she had an ectopic. MD said that ectopics are notorious for funny readings.

~Jen

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